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This report by The Swedish Council on Technology Assessment in Health Care (SBU) reviews, classifies, and grades the scientific literature on cancer chemotherapy in some major tumour types, describes the practice of chemotherapy in Sweden, compares practice with scientific knowledge, and analyses the costs and cost-effectiveness of chemotherapy. The report is intended primarily for decision-makers

BACKGROUND: Owing to the wide spread perception of a possible benefit from paclitaxel in the second-line situation the Nordic Gynecologic Oncology Group (NGOG) conducted two prospective phase II studies of paclitaxel single agent treatment (175 mg/m2, three-hour i.v. infusion with standard pre-medication every third week) in patients with relapsing or progressing epithelial ovarian cancer followin

BACKGROUND: Chemotherapy-induced emesis is one of the most disturbing side effects of cancer therapy. Control of acute emesis has improved substantially during recent years, but control of delayed emesis and nausea remains a challenging problem. The role of 5-HT3 receptor antagonists in the treatment of delayed emesis is disputed.METHODS: Tropisetron, a highly specific 5-HT3 receptor antagonist, w

A trial of decentralised cytostatic (carboplatin + cyclophosphamide) treatment of advanced ovarian cancer under centralised supervision, carried out in the southern health care region, yielded good results. As carboplatin and cyclophosphamide cause myelosuppression which is commonly most manifest two weeks after treatment, increasing dosage intervals and reducing dosages is often necessary. Howeve

BACKGROUND: The locoregional failure rate remains high in advanced cervical carcinoma. Chemotherapy (CT) was added to radiotherapy (RT) in order to increase disease control and to improve 5-year survival.METHODS: CT + RT included cisplatin administered 100mg/m2, d.1 plus 5-fluorouracil 1000 mg/m2 D.1 to 5, ci (120 hrs), q every 3rd week for 3 cycles, followed by RT. RT included external beam irrad

In a controlled prospective randomized study the regimen doxorubicin (A) 40 mg/m2 + melphalan (M) 0.4 mg/kg was compared with A + M + cisplatin (C) 50 mg/m2 given every four weeks in advanced ovarian cancer, FIGO stage III or IV and with serous or anaplastic histology. From 1981 to 1983, 300 patients entered the study and 295 patients were evaluable for response, toxicity and long-term survival. A

A large, consecutive series of 562 patients with endometrial adenocarcinomas was investigated with respect to prognostic factors. In the histopathologic evaluation the World Health Organization (WHO) classification system was used. In addition to that, in moderately differentiated (MD) tumors small areas of solid growth were identified and the proportions of these out of the whole areas of tumor (

To evaluate the efficacy and safety of Navoban (tropisetron) three different Nordic multicentre trials were conducted during the period 1988-92. In all, 1050 patients were recruited from 15 centres. In the first study, Navoban monotherapy was compared with a high-dose metoclopramide cocktail. In the second, Navoban +/- dexamethasone was evaluated for those patients not fully protected by Navoban a

There have been no controlled clinical trials supporting the use of primary cytoreductive surgery. The question remains as to whether the observed survival benefits for patients subjected to primary cytoreductive surgery are an effect of surgical skill or tumour biology. The proponents of tumour biology claim that cytoreductive surgery is a selective procedure, choosing patients with better progno

An open, noncomparative, Nordic multicenter study was carried out during 1991-1992 to evaluate the 5-HT3 receptor antagonist tropisetron (Navoban) as an antiemetic agent for various types of cancer chemotherapy. A total of 630 patients were recruited from 15 centers in Sweden, Denmark, and Finland. Gynecological cancers (60%), breast cancer (15%), and lung cancer (10%) were the main diagnoses. Pri

BACKGROUND: The morphologic spectrum of ovarian mucinous tumors is well known, but the features that predict aggressive behavior are still controversial.METHODS: Ninety-two cases of primary ovarian mucinous tumors with atypical epithelial proliferation and/or stromal invasion were analyzed histologically and by DNA flow cytometry, and the results were correlated with clinical findings.RESULTS: The

BACKGROUND: Chemotherapy-induced emesis is one of the most disturbing side effects in cancer therapy. Thus, antiemetic treatment is a mandatory adjunct in emetogenic chemotherapy.METHODS: Tropisetron (Navoban, Sandoz Pharma Ltd., Basel, Switzerland), a new 5-HT3 receptor antagonist, was compared in a randomized multicenter trial with a high-dose metoclopramide-dexamethasone cocktail for the preven

Granulosa and theca cell tumors of the ovary account for 2-3% of ovarian malignancies. This study includes 54 patients with the diagnosis of granulosa cell tumors of the ovary treated between 1953 and 1987. Median age at diagnosis was 57 (27-83) years. The lesions were staged according to FIGO. The number of patients in various stages was IA, 41; IB, 3; IC, 3; IIB, 6; and III, 1. Median tumor size

In a double-blind, randomised, multicentre study, the efficacy and tolerability of tropisetron and a combination of tropisetron and dexamethasone were compared for the control of nausea and vomiting induced by cisplatin in patients previously not entirely protected by tropisetron monotherapy. In all, 160 women with gynaecological cancers were studied during two consecutive courses of cisplatin-con

All 426 patients with ovarian malignancies registered in the population-based Tumor Registry of the Southeast region of Sweden during 1984 to 1987 were analyzed by survey of the hospital records and population registry data. After comparison with other population-based materials, it seems that the overall survival figures have improved in ovarian cancer. Excluding patients diagnosed at autopsy a 5

Eight hundred thirty-nine clinical stage I endometrial carcinoma patients diagnosed between 1979 and 1988 were treated at the University Hospital in Linköping. Forty-two (5%) had uterine papillary serous carcinoma of which 52% died of their disease. The recurrence rate, defined as new evidence of disease 6 months or more after termination of the initial treatment, was 31% among the UPSC patients c